Primary care services include well-child exams as well as management of acute and chronic health problems. Since the Pediatric Center’s opening at the end of January, over 50 children have been provided with acute care. The Pediatric Center’s nurse practitioner has collaborated with the school nurse in an effort to comply with state required screenings for vision, hearing, scoliosis, and immunizations. Health education sessions will be provided to students in grades kindergarten to six on topics to include nutrition, safety, hygiene, drug and alcohol abuse, and violence abatement. NFL Alumni players will reinforce principles taught in classes by becoming involved with the children through a mentoring program. An education program dealing with anger management is presently being developed. Mental health plans include education classes about mental health issues and continued screening for children experiencing behavior and emotional problems. Mental health screenings were begun in 1999 and are continuing. The Center also works with the Family Support Team at the elementary school in an effort to address behavior and emotional issues.

In 2003, a total of 49 sites were served by the MedShare program. These sites included federally qualified and other nonprofit health centers as well as agencies. Patients from these sites were able to purchase prescription medications at a rate substantially less than the retail price.

A total of 18,251 patients were enrolled in the MedShare program in 2003. The average retail cost of the prescriptions filled was $25.00. The average MedShare cost to patients was $6.00. By paying the MedShare price rather than the retail price, patients saved over $2 million. In addition, a co-pay bank was available to further assist patients who were experiencing substantial financial hardships or required multiple medications. These patients received their medications at a further reduced cost or in some cases at no cost. The MedShare program enabled medically indigent patients access to prescription medications that they may not otherwise be able to afford.

• Created agency eligibility requirements
  
• Established MedShare Pharmacy and OTC warehouse infrastructure
  
• Organized ordering and distribution processes
  
• Developed client eligibility protocols
  
• Set up financial systems and policies
  

OTC

• Purchased required refrigeration units and set up the secured area to store products
  
• Arranged to acquire products through Second Harvest
  
• Applied for medication distributor license
  
• Distributed all products acquired for an OTC demonstration
  

MedShare

• Obtained approval to set up this program from the Ohio Pharmacy Board
  
• Established MedShare distribution sites at Mt. Auburn, East End, and Walnut Hills Health Centers
  
• Initiated contacts to pharmaceutical fee drug programs
  
• Implemented revenue collection system which includes both patient sliding scale co-pays based on medicine cost and the $15 individual or $25 family distribution point contribution used to offset the administration, pharmacy, and delivery overhead
  
• Established policies for medication control and tracking
  
• Established MedShare Clinical and Operations Committees
  
• Signed contracts with Health Resource Center and Crossroad
  
• Discussions are in progress with five additional Ohio and three Kentucky Medshare sites
  
• Was awarded grants from two local foundations to establish indigent client co-payment bank
  

Additional Findings:

There are three established MedShare distribution sites. Over 5,000 prescriptions have been filled by the MedShare pharmacy. The majority of the patients served have chronic medical diseases: hypertension, cardiovascular disease, diabetes, allergies, and/or depression. Over 98% of the patients participating in MedShare are picking up their medications and paying their co-payments.

Outcomes of the MedShare project as of November 2000 are:

• 1097 people had accessed the program; 534 had enrolled
  
• 8 sites were operational
  
• 495 people had enrolled in pharmaceutical patient assistance programs that provide free medications
  
• 97% of patients were picking up their medications and paying co-payments
  
• MedShare had generated $2.38 worth of retail value prescription drugs per dollar invested by the Health Foundation
  

One study of 30 MedShare asthma patients found that, since the patients enrolled in the MedShare program:

• emergency room visits decreased 50%,
  
• urgent care facility visits decreased by 40%, and
  
• no-shows for scheduled doctor visits decreased.

Now entering its third year of operation, MedShare is rapidly expanding. There are presently 25 member sites in southwest Ohio, the Columbus area, and northern Kentucky. Other communities around the region are expressing interest as they hear about the program. In 2000, MedShare served 1,986 patients. This number nearly tripled in 2001 to more than 4,600 patients served. Approximately 26,000 prescriptions were filled during 2001. The projected number for 2002 is 130,000, a five-fold increase.

A Patient Assistance Coordinator has been hired to help patients gain access to drugs offered for free by various pharmaceutical companies. A third resource for medicines is the Sharing The Care program run by Pfizer. We estimate that the combined savings to patients in 2001 from all of these programs was $521,000.

Filling errors were reduced in 2004 due to more efficiency in the MedShare   program.

Prescription volume increased by two percent (2%) from 106,008 in 2003 to 108,000 in 2004. This increase was a significant accomplishment as several high-volume Columbus sites dropped out of the program. Bar coding was not implemented, although there are plans to implement it in 2005.

MedShare maintained the same staffing level. A MedShare Manager is now being recruited and is expected to be on board within the next 2 months. One of the manager’s responsibilities will be to enroll more partners into MedShare to maintain and generate revenue for the program.

23,396 patients were enrolled during the grant period. The overall saving to those patients was $2,052,152.

MedShare was able to arrange for eligible seniors to access a Medicare approved drug card to obtain $600 in 2004 and 2005 using MedShare’s lower prices. There is a gap in proposed coverage so the need for seniors to    have access to MedShare continues.